EQUIP for MIPS

Participation in the SHINE of Missouri health information exchange can help you EQUIP for MIPS in a number of ways.

Promoting Interoperability

CMS has renamed the Advancing Care Information performance category to Promoting Interoperability (PI) to focus on patient engagement and the electronic exchange of health information using certified electronic health record technology (CEHRT). This performance category replaced the Medicare EHR Incentive Program for EPs, commonly known as Meaningful Use. This is done by proactively sharing information with other clinicians or the patient in a comprehensive manner. This may include: sharing test results, visit summaries, and therapeutic plans with the patient and other facilities to coordinate care.

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Improvement Activities

This performance category includes an inventory of activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care. The inventory allows you choose the activities appropriate to your practice from categories such as enhancing care coordination, patient and clinician shared decision-making, and expansion of practice access.

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Quality

This performance category replaces PQRS. This category covers the quality of the care you deliver, based on performance measures created by CMS, as well as medical professional and stakeholder groups. Select six performance measures to report.

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Cost

This performance category replaces the VBM. The cost of the care you provide will be calculated by CMS based on your Medicare claims. MIPS uses cost measures to gauge the total cost of care during the year or during a hospital stay.

What?

There are four performance categories that make up your final MIPS score. Your 2019 final score determines your payment adjustment for 2021. These categories are: Quality, Promoting Interoperability, Improvement Activities, and Cost.

Why?

MIPS was designed to tie payments to quality and cost efficient care, drive improvement in care processes and health outcomes, increase the use of health care information, and reduce the cost of care.

When?

The MIPS Performance Year begins on January 1 and ends on December 31 each year. Program participants must report data collected during one calendar year by March 31 of the following calendar year. For example, program participants who collected data in 2018 must report their data by March 31, 2019 to be eligible for a payment increase and to avoid a payment reduction in 2020.

CONSIDER THIS

Based upon the Merit-based Incentive Payment System (MIPS), there is revenue to be gained or revenue at risk based upon how you perform. If, for example, you receive $200,000 in Medicare Reimbursement annually, the financial impact according to the MIPS schedule is as follows the first year:

Frequently Asked Questions

Are you required to submit data to the Quality Payment Program also known as MIPS?

This tool will display MIPS eligibility based on a TIN and NPI combo. For physicians who work at multiple facilities with different TIN’s, it’s possible that those physicians could be required to submit MIPS data from multiple locations.